ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2021
The Role of the Transdiaphragmatic Pressure Gradient (TGP) in the Pathophysiology of Proximal Reflux.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- Association between body mass index at different levels and risk of gastroesophageal reflux disease: a systematic review with dose-response meta-analysis.Frontiers in physiology · 2025Pooled it
- Changes in esophageal contractile and barrier function in lung transplant recipients.Esophagus : official journal of the Japan Esophageal Society · 2025Article
- Selective dysfunction of the crural diaphragm in patients with chronic restrictive and obstructive lung disease.Neurogastroenterology and motility · 2024Article
- Antireflux surgery to prevent the progression from Barrett's esophagus to esophageal adenocarcinoma: yes or no?Journal of gastrointestinal oncology · 2023Article
- LAPAROSCOPIC ANTIREFLUX SURGERY: ARE OLD QUESTIONS ANSWERED? USEFUL FOR EXTRA-ESOPHAGEAL SYMPTOMS?Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2022Article
Corrections and comments
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Authors and funding
3 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAn increased transdiaphragmatic pressure gradient (TGP) is a main element for distal gastroesophageal reflux disease (GERD). The role of TGP for proximal reflux is still unclear. This study aims to evaluate the presence, severity, and importance of proximal reflux in relationship to the TGP, comparing healthy volunteers, obese individuals, and patients with chronic obstructive pulmonary disease (COPD).
methodsWe studied 114 individuals comprising 19 healthy lean volunteers, 47 obese individuals (mean body mass index 45 ± 7 kg/m
resultsPathologic distal GERD was found in 0, 44, and 57% of the volunteers, obese, and COPD groups, respectively. pAET was similar among groups, only higher for obese individuals GERD + as compared to obese individuals GERD - and COPD GERD -. pAET did not correlate with any parameter in healthy individuals, but it correlated with AP in the obese, TP in the COPD individuals, and TGP and DeMeester score in both groups. When all individuals were analyzed as a total, pAET correlated with AP, TGP, and DeMeester score. DeMeester score was the only independent variable that correlated with pAET.
conclusionsOur results show that (a) TGP is an important mechanism associated with distal esophageal acid exposure and this fact is linked with proximal acid exposure and (b) obesity and COPD both seem to be primary causes for GERD but not directly for proximal reflux.
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